“Self care” is the new buzzword in Canadian medical schools – and for good reason. A 2016 meta-analysis showed that nearly 1/3 of Canadian medical students experience depression or depressive symptoms. To compare, Health Canada states that the rate of depression in the general population is around 8%. One of my case tutors told our group that almost 80% of the second year class was on anti-anxiety medications by the end of first term. While uncorroborated, it isn’t that hard to believe. These numbers aren’t – or at least shouldn’t be – surprising, giving the culture of medicine.
Medical school puts you through the wringer. The application process is grueling – it takes nearly an entire year in Canada, and is wrought with uncertainty and self-doubt. The multiple mini interview format is set up to really test applicants under stress, and isn’t made easier by being surrounded by hundreds of equally if not more qualified applicants who are just as stressed out as you. And then once you get your acceptance and you start school, you realize just how incompetent you are. The days are long, the expectations are high, and at times, it feels all-consuming. There isn’t exactly a lot of time to cook well, exercise, study hard, volunteer, do research, sleep, and spend time with friends and family. All things considered, it’s not difficult to see why many medical students face mental health challenges in school.
Don’t get me wrong – I still think being a medical student is the best job in the world, and I wouldn’t trade it for a thing. But it is grueling, and it does take its toll.
In order to combat the rising numbers of anxiety, medical schools (including UBC) are adding a lot of emphasis on self-care. They do a great job at encouraging us to look out for each other, to exercise, to spend time doing things we enjoy, and to generally lead balance lives. The selling point is always this:
“You can’t pour from an empty cup”
In other words: take care of yourself, because if you don’t, you won’t be able to provide the best care for your patients. It’ll help you avoid burnout, so you can keep working and helping your patients get healthy.
That statement isn’t wrong, and it certainly convinces a group of first year medical students who are eager to do whatever they can to be the best doctors they can be that balance is important. But what does it say about the purpose of self-care? Is it really about taking care of yourself?
I would argue that it isn’t. Convincing medical students that self-care is important so they can provide better care to others perpetuates the attitude that self-sacrifice, and to an extent, dehumanization of the self in medicine is heroic. But it’s that attitude that’s gotten us into this trouble with mental health in the first place. Medical students, residents, and staff docs often pour so much into their careers and the care of their patients that their own needs go unaddressed.
Self-care framed in this light isn’t about you. It’s about other people.
Self-care is important. But not just so that you can better care for your patients. It’s important because you are a person – and you deserve to be cared for.
What do you think about the emphasis on self-care in medical school? How do you balance caring for yourself with caring for others? -H